scholarly journals Patient blood management» strategy in pregnant women with the risk of massive obstetric bleeding

2021 ◽  
Vol 6 ◽  
pp. 50-55
Author(s):  
S.P. Posokhova ◽  
I.I. Ryazantcev ◽  
N.V. Baylo ◽  
I.V. Fetshenko
Keyword(s):  
Pregnant Women ◽  
Placenta Previa ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Patient Blood Management ◽  
Placental Pathology ◽  
Blood Management ◽  
Moderate Anemia ◽  
Invasive Placenta

The objective: a determination of the effectiveness of anemia treatment with intravenous iron (III) hydroxide sucrose complex in pregnant women with pathological placentation, as the first stage of “patient blood management” before delivery.Materials and methods. Among 86 pregnant women with placental pathology, 58 (70.7 %) had anemia. Severe anemia with a hemoglobin level <70 g/l was in 13 (22.4 %), moderate anemia with a hemoglobin level <90 g/l — in 19 (32.8 %). The first group included 18 (31.1 %) pregnant women with placenta previa with periodic blood loss during pregnancy. The second group consisted of 40 (68.9 %) pregnant women with invasive placenta. The gestation period in all women was 33+6 weeks. Anemia was treated by intravenous administering iron (III) hydroxide sucrose complex 3 times a week (5-7 injections).Results. The main factor that led to pathological placentation was the scar on the uterus. In pregnant women in the second group with invasive placenta, the scar on the uterus was in 38 (95 %) women. Severe anemia was present in 2 (11.1 %) pregnant women with placenta previa that was in 2.4 times less than in pregnant women with invasive placenta — 11 (27.5 %). Moderate anemia was present in 4 (22.2 %) women in the first group and in 15 (37.5 %) in the second group.In pregnant women with severe anemia, after 5–7 injections of the drug iron (III) hydroxide sucrose complex the level of hemoglobin increased significantly by 30 g/l, the number of erythrocytes increased to 2.8×1012/l, serum iron – in 2 times, the level of ferritin – to 19.6 μg/l and transferrin content decreased. For pregnant women with moderate anemia, 3–5 injections of the drug were sufficient to normalize the indicators. Normalization of blood parameters allowed to reduce the risk of bleeding, the number of blood transfusions and improve treatment outcomes.Conclusions. Timely diagnosis of the iron deficiency anemia in pregnant women with placental pathology is an important means of preventing massive blood loss and reducing the number of blood transfusions, as the first stage of the strategy “patient blood management”.Intravenous iron (III) sucrose complex hydroxide has demonstrated a high clinical efficacy in the treatment of iron deficiency anemia in pregnant women with placental pathology and can be recommended for widespread use in practical medicine.

scholarly journals The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Ilknur Col Madendag ◽  
Mefkure Eraslan Sahin ◽  
Yusuf Madendag ◽  
Erdem Sahin ◽  
Mustafa Bertan Demir ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Fetal Weight ◽  
Deficiency Anemia ◽  
Control Group ◽  
Third Trimester ◽  
Mild Anemia ◽  
Moderate Anemia ◽  
Anemia Group

Aim. The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. Methods. A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26+0 and 30+0 weeks of gestation and delivered singletons between 37+0 and 41+6 weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) < 7 mg/dl (n = 80), (2) Hb 7–9.9 mg/dl (n = 320), (3) Hb 10–10.9 mg/dl (n = 1300), and (4) Hb > 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. Results. The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m2, nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 ± 80 g in the severe anemia group, 3050 ± 100 g in the moderate anemia group, 3350 ± 310 g in the mild anemia group, and 3400 ± 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). Conclusion. The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight.

scholarly journals A study for efficacy and safety of ferric carboxymaltose versus iron sucrose in iron deficiency anemia among pregnant women in tertiary care hospital

2019 ◽  
Vol 8 (6) ◽  
pp. 2280
Author(s):  
Divyani Agrawal ◽  
Deepa Lokwani Masand
Keyword(s):  
Iron Deficiency ◽  
Adverse Events ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Efficacy And Safety ◽  
Anemia During Pregnancy

Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.

scholarly journals Treatment of Anemia of Chronic Disease with True Iron Deficiency in Pregnancy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Gabriela Amstad Bencaiova ◽  
Alexander Krafft ◽  
Roland Zimmermann ◽  
Tilo Burkhardt
Keyword(s):  
Chronic Disease ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Human Erythropoietin ◽  
Anemia Treatment ◽  
In Pregnancy

Objective.We assess and compare the efficacy of anemia treatment in pregnant women with anemia of chronic disease with true iron deficiency and in women with iron deficiency anemia.Study Design.Fifty patients with moderate anemia (hemoglobin 8.0–9.9 g/dl) and iron deficiency (ferritin < 15 μg/l) were treated in the Anemia Clinic at the Department of Obstetrics.Results.All patients showed stimulation of erythropoiesis as evidenced by an increase in reticulocyte count at day eight of therapy and showed an increase in hemoglobin and hematocrit at the end of therapy (p<0.001). The target hemoglobin (≥10.5 g/dl) was achieved in 45/50 women (90%). 12 patients showed anemia of chronic disease with true iron deficiency (12/50; 24%). Seven women (7/12; 59%) with anemia of chronic disease and iron deficiency responded well to anemia treatment. 50% of women with anemia of chronic disease and iron deficiency (3/6) responded well to intravenous iron, and 67% (4/6) responded well to the combination of intravenous iron and recombinant human erythropoietin.Conclusion.Because of frequent true iron deficiency in pregnant women with anemia of chronic disease, anemia of chronic disease in pregnancy is often falsely diagnosed as iron deficiency anemia.

scholarly journals The Important Role for Intravenous Iron in Perioperative Patient Blood Management in Major Abdominal Surgery

2016 ◽  
Vol 264 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Bernd Froessler ◽  
Peter Palm ◽  
Ingo Weber ◽  
Nicolette A. Hodyl ◽  
Rajvinder Singh ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Intravenous Iron ◽  
Major Abdominal Surgery ◽  
Patient Blood Management ◽  
Blood Management

scholarly journals Determinants of Dietary Diversity Consumption and Nutritional Status of Pregnant Women Attending Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia

2020 ◽  
Vol 1 (1) ◽  
pp. 51-79
Author(s):  
Haile Abebe ◽  
◽  
Teshome Alemteshay ◽  
Keyword(s):  
Logistic Regression ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Dietary Diversity ◽  
Armed Forces ◽  
Antenatal Clinic ◽  
Severe Anemia ◽  
Factors Affecting ◽  
Specialized Hospital ◽  
Moderate Anemia

The nutritional status of a woman during pregnancy is important as a suboptimal diet impacts negatively on the health of the mother, the fetus and the newborn. There is limited knowledge in the area of malnutrition and factors’ affecting it among pregnant women despite evidence showing that maternal nutrition has important direct and/or indirect consequences for all other age. The objective of the study was to assess the determinants of dietary diversity and nutritional status of pregnant women attending antenatal clinic at Armed Forces Comprehensive Specialized Hospital. The study was cross-sectional and conducted by using both quantitative and qualitative methods. A multistage sampling procedure was employed to draw 320 samples, pregnant women. The women were selected in random through balloting among the first five pregnant women to arrive at the antenatal clinic and thereafter systematic sampling was used and every fourth woman that arrived were sampled until the sample size is met. The data were analyzed by using a software STATA version 14. Descriptive statistics to determine the dietary diversity and nutritional status were done and also to characterize the nutritional status. The statistical model namely, logistic and ordered logistic regression was used for factors affecting the dietary diversity and nutritional status. A P value of <0.1 was considered statistically significant. According to the logistic model interpretation, negative relation implies that the dependent and independent variables are inversely related; while the positive association is the outcome and independent variable have direct relations. The findings of the descriptive analysis indicated that low dietary diversity was experienced by 61.56 percent of the respondents and the rest of the study population was in a high dietary diversity. Based on Mid-upper arm circumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent were moderately malnourished and 96.25 percent were well nourished. Findings from logistic regression revealed that income, meals that were eaten in the last 24 hours, and anemia have positively and significantly affects dietary diversity while not taking iron-fortified foods affects negatively. The results from the ordered logit model indicate that severe undernutrition is determined by not taking micronutrient daily positively where ever income and cleaning utensil properly impact negatively, although moderate undernutrition is associated with not taking micronutrient daily positively and negatively with cleaning utensil properly. Though being nourished is affected by not taking micronutrient daily negatively and positively by cleaning utensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent, 11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normal hemoglobin level respectively. The results from the multinomial regression model reveal that severe anemia is negatively associated with dietary diversity. At the same time, moderate anemia is affected positively by not taking micronutrient daily and negatively by age, dietary diversity score and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-off was affected positively by age, dietary diversity and morbidity, negatively affected by not taking micronutrient daily. Finally, the findings conclude that dietary diversity and nutritional status were very poor and socio-demographic, socio-economic, micronutrient supplementation, morbidity, environmental factors, and dietary diversity influence the nutritional status of pregnant women. It is recommended that promotion of dietary diversity and modification of diets be carried out through practical demonstrations in the community and health facilities and there should be income generation practices and entrepreneur encouragements should be practiced.

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